 <div class="modal fade" id="registro" tabindex="-1" role="dialog" aria-labelledby="myModalLabel" aria-hidden="true">
         
    <div class="modal-dialog">
    <div class="modal-content" style="border-radius:0 !important;position:relative !important;">
<!--        <form method='post' action='../logic/insertarOferta.php' name='editarOferta<?php echo $i ?>' autocomplete="off">
            <input type="hidden" name="pid" value="<?php echo $plan['idPlan']; ?>">-->
            <!--<input type="hidden" name="uid" value="<?php // echo $plan['idUsuario'] ?>">-->
        <div class="aspa" data-dismiss="modal" aria-hidden="true" style="right:-10px;top:-10px;" title="Cerrar">
            <i class="glyphicon glyphicon-remove"></i>
        </div>
        <div class="modal-header" style="color:white;background-color:#5789ae;color:white;border-bottom:black solid 2px;float:none;">
            <div class="cartel" style="padding:0;margin:0;text-align:left;font-size:20px;">
                REGISTRO
            </div>
        </div>

        <div class="modal-body" style="padding-bottom:0">
           <form action="logic/validarRegistro.php" method="post" class="form" role="form">
            <div class="row">
                <div class="col-xs-6 col-md-6">
                    <input class="input" name="nombre" placeholder="Nombre" type="text" required />
                </div>
                <div class="col-xs-6 col-md-6">
                    <input class="input" name="apellidos" placeholder="Apellidos" type="text" required />
                </div>
            </div><br>
            <div class="row">
                <div class="col-xs-6 col-md-6">
                    <select name="idProvincia" id="provincia" class="campo" style="width:265px;margin-left:0;background-color:white">
                        <option>Provincias</option>
                    </select>
                </div>
                <div class="col-xs-6 col-md-6">
                    <select name="idMunicipio" id="municipio" class="campo" style="width:265px;margin-left:0;background-color:white">
                        <option>Municipios</option>
                    </select>
                </div>
            </div><br>
            <input class="input" name="reg_email" placeholder="Email" type="email" autocomplete="off"/><br><br>
            <input class="input" name="reg_pass" placeholder="Elige tu contraseña" type="password" autocomplete="off"/><br><br>
            <input class="input" name="reg_repass" placeholder="Repite tu contraseña" type="password" autocomplete="off" /><br><br>
            <label for="">Fecha de Nacimiento</label>
            <div class="row">
                <div class="col-xs-4 col-md-4" style="width:33.5%">
                    <select class="campo" name="dia" style="margin-left:0px;width:100%;background-color:white">
                        <option value="Dia">Dia</option><option value="1">1</option><option value="2">2</option><option value="3">3</option><option value="4">4</option><option value="5">5</option><option value="6">6</option><option value="7">7</option><option value="8">8</option><option value="9">9</option><option value="10">10</option><option value="11">11</option><option value="12">12</option><option value="13">13</option><option value="14">14</option><option value="15">15</option><option value="16">16</option><option value="17">17</option><option value="18">18</option><option value="19">19</option><option value="20">20</option><option value="21">21</option><option value="22">22</option><option value="23">23</option><option value="24">24</option><option value="25">25</option><option value="26">26</option><option value="27">27</option><option value="28">28</option><option value="29">29</option><option value="30">30</option><option value="31">31</option>
                    </select>
                </div>
                <div class="col-xs-4 col-md-4" style="width:33%">
                    <select class="campo" name="mes" style="margin-left:0px;width:100%;background-color:white">
                        <option value="Mes">Mes</option><option value="01">Enero</option><option value="02">Febrero</option><option value="03">Marzo</option><option value="04">Abril</option><option value="05">Mayo</option><option value="06">Junio</option><option value="07">Julio</option><option value="08">Agosto</option><option value="08">Septiembre</option><option value="10">Octubre</option><option value="11">Noviembre</option><option value="12">Diciembre</option>
                    </select>
                </div>
                <div class="col-xs-4 col-md-4" style="width:33.5%">
                    <select class="campo" name="anyo" style="margin-left:0px;width:100%;background-color:white">
                        <option value="Año">Año</option><option value="2013">2013</option><option value="2012">2012</option><option value="2011">2011</option><option value="2010">2010</option><option value="2009">2009</option><option value="2008">2008</option><option value="2007">2007</option><option value="2006">2006</option><option value="2005">2005</option><option value="2004">2004</option><option value="2003">2003</option><option value="2002">2002</option><option value="2001">2001</option><option value="2000">2000</option><option value="1999">1999</option><option value="1998">1998</option><option value="1997">1997</option><option value="1996">1996</option><option value="1995">1995</option><option value="1994">1994</option><option value="1993">1993</option><option value="1992">1992</option><option value="1991">1991</option><option value="1990">1990</option><option value="1989">1989</option><option value="1988">1988</option><option value="1987">1987</option><option value="1986">1986</option><option value="1985">1985</option><option value="1984">1984</option><option value="1983">1983</option><option value="1982">1982</option><option value="1981">1981</option><option value="1980">1980</option><option value="1979">1979</option><option value="1978">1978</option><option value="1977">1977</option><option value="1976">1976</option><option value="1975">1975</option><option value="1974">1974</option><option value="1973">1973</option><option value="1972">1972</option><option value="1971">1971</option><option value="1970">1970</option><option value="1969">1969</option><option value="1968">1968</option><option value="1967">1967</option><option value="1966">1966</option><option value="1965">1965</option><option value="1964">1964</option><option value="1963">1963</option><option value="1962">1962</option><option value="1961">1961</option><option value="1960">1960</option><option value="1959">1959</option><option value="1958">1958</option><option value="1957">1957</option><option value="1956">1956</option><option value="1955">1955</option><option value="1954">1954</option><option value="1953">1953</option><option value="1952">1952</option><option value="1951">1951</option><option value="1950">1950</option><option value="1949">1949</option><option value="1948">1948</option><option value="1947">1947</option><option value="1946">1946</option><option value="1945">1945</option><option value="1944">1944</option><option value="1943">1943</option><option value="1942">1942</option><option value="1941">1941</option><option value="1940">1940</option><option value="1939">1939</option><option value="1938">1938</option><option value="1937">1937</option><option value="1936">1936</option><option value="1935">1935</option><option value="1934">1934</option><option value="1933">1933</option><option value="1932">1932</option><option value="1931">1931</option><option value="1930">1930</option><option value="1929">1929</option><option value="1928">1928</option><option value="1927">1927</option><option value="1926">1926</option><option value="1925">1925</option><option value="1924">1924</option><option value="1923">1923</option><option value="1922">1922</option><option value="1921">1921</option><option value="1920">1920</option><option value="1919">1919</option><option value="1918">1918</option><option value="1917">1917</option><option value="1916">1916</option><option value="1915">1915</option><option value="1914">1914</option><option value="1913">1913</option><option value="1912">1912</option><option value="1911">1911</option><option value="1910">1910</option><option value="1909">1909</option><option value="1908">1908</option><option value="1907">1907</option><option value="1906">1906</option><option value="1905">1905</option><option value="1904">1904</option><option value="1903">1903</option><option value="1902">1902</option><option value="1901">1901</option><option value="1900">1900</option>
                    </select>
                </div>
            </div><br>
            <label for="">Sexo</label><br>
            <label class="radio-inline">
                <input type="radio" name="sexo" id="inlineCheckbox1" value="1" />
                Hombre
            </label>
            <label class="radio-inline">
                <input type="radio" name="sexo" id="inlineCheckbox2" value="2" />
                Mujer
            </label>
            <br />
            <br />
        </div>
      <div class="modal-footer" style="padding:10px 0 10px 0;text-align:center">
        <input type="submit" class="btn btn-info boton" value="Enviar">
      </div>
    </form>
</div>
    </div>
 </div>
